Last Monday, the Race and Health subcommittee held its third discussion group of the academic year entitled, “Why mothers die: the racial disparities in maternal health.” The event was well-attended with twenty participants, excluding the subcommittee members. We were motivated to focus on this public health issue because of a 2020 MBRRACE-UK report, which revealed that in the UK Black women are four times and Asian women are two times more likely to die in pregnancy or childbirth than their white counterparts. This measure is a decrease from fivefold for Black women (and a stagnation for Asian women) according to the MBRRACE-UK’s 2018 report on this topic, but this small change is not enough. More importantly, what indicates the “end” to racial disparities in maternal mortality? Is it when the rates of minority ethnic and white women are the same? These contentions were some of the issues we explored in our discussion group in addition to the history of obstetric racism, physiological effects of racial discirmination, and increasing shifts toward “culturally competent” obstetric care.
The discussion ended on a more inspiring note by examining interventions for this public health issue. While systemic changes are clearly critical, we focused on community-led solutions, like doula services and the JJ Way, that can engender meaningful change. The image above is a screenshot of a Menti word cloud created by participants in response to the question: “What types of solutions can we implement to fight racialized disparities within maternal mortality?”. Despite the overwhelmingly alarming reality of this public health crisis, it is important to be hopeful as hope sustains attention and drives action. Our goal for this discussion group was to educate people about the racialized experiences of pregnancy and childbirth, and we hope to continue raising this awareness beyond our event. We have shared below a list of media on racial disparities in maternal health. We encourage you, reader, to watch and read and share these sources with others.
Additional sources
Obstetric racism: its historical roots and physiological impact
TED talk: How racism harms pregnant women — and what can help www.ted.com/talks/miriam_zoila_perez_how_racism_harms_pregnant_women_and_what_can_help/footnotes?referrer=playlist-talks_for_when_you_re_expectin#t-391588
Vox video: The US medical system is still haunted by slavery https://www.youtube.com/watch?v=IfYRzxeMdGs&ab_channel=Vox
PhD dissertation on historical exclusion of Black women from midwifery: https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1422&context=gc_etds
Interview with Dr. David Williams, an African American sociologist who developed ways to measure the racism’s impact on physical health: https://www.colorlines.com/articles/meet-man-who-proved-discrimination-can-make-you-physically-sick
Study on racial bias in pain assessment and treatment against Black Americans: https://www.pnas.org/content/pnas/113/16/4296.full.pdf
Racial disparities in maternal health: an overview of this public health crisis
Article on maternal mortality’s impact on Black women in the UK: https://www.theguardian.com/global-development/2021/jan/15/black-women-in-the-uk-four-times-more-likely-to-die-in-pregnancy-or-childbirth
Guardian video on maternal care among Black women during the Covid-19 pandemic: https://www.youtube.com/watch?v=kNeY0AAPe5I&ab_channel=TheGuardian
Article about the high prevalence of infertility among Black women: https://link.springer.com/article/10.1007/s10815-020-01863-x
Ways to intervene
Article about implementation of a doula program: https://www.mlive.com/news/grand-rapids/2020/08/kent-county-agencies-launch-doula-program-to-address-racial-birth-disparities.html
Article about importance of identifying targeting bias to improve maternal care outcomes for Black women: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30312-6/fulltext
Vice mini-documentary on how doctors in Georgia (USA) are contending with high maternal mortality rates https://www.youtube.com/watch?v=dT0rL4TvX-I&ab_channel=VICE
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